2783 X875 e /fit Cts 474 ,
m NO. LOT NO.
w PIONATI N R ELECTRICAL PERIv11TrAY 2 6 1964 c OF CUPERTINO
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Date nt*S'�r d 1 ire
19�� Permit No.
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° a Fee S 7--V
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< Application is hereby made to the City of Cupertino for a permit to install electrical
r wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
W wiring and/or fixtures in accordanre with the provisions of the Electrical Code of the
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a City of Cupertino, and all other laws applicable thereto. I
z J Use of Premises "
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3 a Owner Address s.
p a By _ Address
a o ^ ,£5'r8[L3.�oa, AGENT Approved C` ' Ll
—l) Phone: TX G ]'If X-0 ELECTRICAL INSPECrO2
State License: /3/ 5 �7 "— --
NEW RPL FEES
Size Service Conduit----------------------Number of Outlets------------------ _-. -- ---------- ------ -- ----
Size Service Wires--------------------------Number of Switches_...-.......... ..--.---- --------- -----.-----
Size Service Switch. Number of Receptacles------------ --- --- _ ---------- ----__.-_--
Size Sub Feed Conduit------------------Number of Fixtures.... . --- - /1), zo
._..-'-- -----... .-------.-..
Size Sub Feed Wires ...Ranges................ KW-------------- -
Number of Circuits------------------ Oven .............. KW-------------- ---------- --------- -------------
Number of Meters--_--------------------Signs---------- Transformers-------- -- - ---- ---------- ---.....-.-..-
Misc.----------------------.---_-----.---Dryers..----.......... .................... ..._---- ---.----- ------------
Motors------------------ HP--------------- Phase................---- Permit Fee $1.00
Motors................_-- HP--------------- Phase....................
Motors.................... HP------------- .... Phase.................... H P Charge.. --------- ..-..----
----
TOTAL FEES- �I ��' -0
RECORD OF INSPECTION APPROVALS '
Rough Wiring................ ---------------------------- Fixtures -.. ......-_- -
DAT[ INSPECTOR D[T[/ INSPECTOR
Finish Wiring ----------------�-------------- Motots ----- ------'". ... . -c....-----......
DR[ IN[PECTOR pIR f��l yR(Dyly-1
Final - 'C .'.------- --'---�--........----....--------
DATi' IRIPEcroN